Verifying the type of incision used for a previous cesarean

You and your doctor will review your medical records to verify the
type of
cesarean incision(s) you have had. Your visible scar
on the skin may not be the same as the incision made in the uterus.

For more than 20 years, doctors typically have made a low,
side-to-side (transverse) incision across the uterus for a cesarean delivery.
However, for an emergency cesarean or delivery of a very premature (28 to 32
weeks) baby by cesarean, a different type of incision may have been used to
save time or to safely remove your baby.

If an incision was made up and down (vertically) into the upper part of the uterus during a previous
cesarean delivery,
vaginal birth after cesarean (VBAC) is not recommended. This type of incision greatly increases the
risk of uterine rupture during labor.

If an incision was stitched
with a single-layer closure, rather than a double-layer,
the risk of uterine rupture is higher during VBAC.1, 2

If the incision was
made from side to side (transverse) and low on the uterus, VBAC is generally considered safe for most women.

If
an incision was made up and down (vertically) into only the lower part of the uterus during a previous cesarean delivery, VBAC is as
safe as with a low transverse incision scar.2

Citations

Bujold E, et al. (2002). The impact of single-layer or
double-layer closure on uterine rupture. American Journal of Obstetrics and Gynecology, 186(6): 1326–1330.

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